Adult Stem CellsOctober 2007
By Denis Rodgerson, PhD, Ron Rothenberg, MD, FACEP, and Wayne A. Marasco, MD, PhD
Better Long-Term Cardiac Health
Adult stem cell therapies have also shown clinical benefit in severe chronic heart disease, such as congestive heart failure, of which almost half a million new cases are diagnosed each year. In one study by Brehm and Strauer, bone marrow-derived stem cells were transplanted directly into the heart tissue of 18 male patients who had suffered a heart attack between five months and 8.5 years earlier.18 These patients had progressive chronic heart failure with reduced left ventricular function. A group of patients who did not receive any cell therapy served as controls. After three months, the researchers found that the area of heart tissue damaged by disease was reduced, while oxygen uptake, energy metabolism and left ventricular function all increased compared with the control group, who showed no significant changes in these parameters.
In another study, Patel and colleagues studied 20 patients with severe chronic heart disease and very poor left ventricular function classified as chronic heart failure.19 All 20 patients received bypass surgery to improve blood flow. In addition, half of the patients also received an infusion of adult stem cells during surgery, which were injected into the most severely compromised regions of the heart. Six months after surgery, the left ventricular function of the stem cell-treated group increased substantially compared with the control group. The improvement was so great that the stem cell recipients were no longer defined as having chronic heart failure.
Banking Stem Cells for Heart Health
It has been suggested that an alternative to stem cell infusion is to administer growth factors that are produced naturally in the body. The use of these chemicals, such as granulocyte colony-stimulating growth factor, alone stimulates the endogenous production of stem cells, which might obviate the need for stem cell infusion. However, a defined benefit from this therapy
has not yet been established20 and some evidence suggests that the use of stem cells immediately after a heart attack may even be detrimental.21 Furthermore, there is mounting evidence that those factors that precipitate the onset of heart disease—such as hypertension, diabetes, smoking, and others—also impact the effectiveness of stem cells in terms of their ability to migrate, transdifferentiate, and proliferate. The benefits of banking stem cells before the onset of disease will undoubtedly prove to be clinically important as the use of these therapies becomes more widespread. Despite the uncertainties about their mechanisms of action, scientists broadly agree on the potential of regenerating damaged heart tissue using a patient’s own stem cells to improve cardiac function and performance.22
Autoimmune and Neurological Conditions
Adult stem cells could also offer hope for patients with autoimmune and neurodegenerative diseases.
In autoimmune disorders, the body begins to produce a type of white blood cells called T lymphocytes and protective proteins called antibodies, which, instead of protecting the body against invasive microbes and cancers, attack its own cells and organs. There are more than 70 different types of autoimmune disorders, for example, multiple sclerosis, rheumatoid arthritis, systemic sclerosis (scleroderma), systemic lupus erythematosus, and juvenile idiopathic arthritis. As a class, autoimmune diseases affect approximately 5% of the US population, with common conditions such as systemic lupus erythematosus affecting 1.5 million people, mostly young women. The standard treatment for autoimmune diseases generally consists of immunosuppression, anti-inflammatory medication, or anti-malarial medication, in addition to supportive care. In cases that do not respond to standard treatment or are considered life- or organ-threatening, high doses of immunosuppressive medication have been proposed as a treatment option to eliminate the T cells causing the autoimmune response. However, such high doses also suppress the bone marrow’s production of blood cells (known as “myelosuppression”), necessitating rescue therapy with transfused hematopoietic (blood cell-forming) stem cells.
It has been theorized that regenerating bone marrow with transplanted stem cells normalizes the immune system.23,24 The concept of stem cell therapy following immunosuppressive therapy for autoimmune diseases has led to the publication of consensus guidelines and the initiation of a number of well-controlled clinical trials.25,26 To date, more than 700 patients have received transplants using their own stem cells as treatment for severe autoimmune diseases,27 including 183 patients with multiple sclerosis,28 76 patients with severe rheumatoid arthritis,29 102 patients with systemic sclerosis (scleroderma),30,31 103 patients with systemic lupus erythematosus,32-34 and, most recently, 15 individuals with new onset type I diabetes.35 Numerous studies using adult stem cells to treat other autoimmune diseases such as Crohn’s disease, Behcet’s disease, and relapsing polychondritis have also been published.36,37
Early studies in patients with neurodegenerative diseases—some of which may represent autoimmune processes—have shown promising results, suggesting that stem cells might offer hope for people with neurological disorders, perhaps even for prevalent conditions such as Parkinson’s disease.38-41
Although the clinical outcomes of stem cell treatments have been variable, most of the studies in this field have shown significant amelioration of disease activity, improvement in serological (blood) markers, and either stabilization or reversal of organ dysfunction. The preliminary conclusions of these studies are sufficiently encouraging to proceed to randomized prospective trials of stem cell transplantation for autoimmune diseases as a group, and particularly for those that are most severe and debilitating. Similarly, scientists believe that stem cells therapies offer compelling hope for neurological conditions, and are further exploring their applications for these debilitating disorders.
Current and Future Stem Cell Therapies
Importantly, all of the studies that have been mentioned so far were carried out using stem cells that were collected after the onset of disease. It is intriguing to speculate on the improvement in outcome that might be achieved if a patient’s own stem cells were available before the onset of disease. The table on page 46 summarizes the current status of regenerative therapy, divided into those diseases being treated with adult stem cells today and those in which experimental evidence from animal studies strongly indicates potential benefits in the future.
Adult stem cells may one day yield cures for the most dreaded diseases that plague adults. A plentiful supply of adult stem cells for personal use collected while healthy and available may offer all adults powerful insurance against the consequences of a range of diseases, both chronic and acute, that is growing daily. Only by having a readily accessible source of stem cells can the full benefits of regenerative medicine be realized. While it remains to be seen whether adult stem cells can prevent or reverse aging or extend life span, ongoing research promises to propel the field of regenerative medicine forward. Regardless of these unanswered questions, it is clear that banking stem cells for long-term storage may truly represent a “bio-insurance policy” that can help provide for your optimal health in the future.
Denis Rodgerson, PhD: NeoStem California Laboratory, 637 South Lucas Avenue, Suite 508, Los Angeles, CA 90017.
Ron Rothenberg, MD, FACEP: California HealthSpan Institute, 320 Santa Fe Drive, Encinitas, CA 92024.
Wayne Marasco, MD, PhD: Department of Cancer Immunology and AIDS, Dana-Farber Cancer Institute, Harvard Medical School, 44 Binney Street, Boston, MA 02115.
Disclosures: All three authors have a financial interest in NeoStem, Inc. (www.neostem.com), a company that specializes in the banking and long-term storage of adult stem cells.
If you have any questions about the scientific content of this article, please call one of our Health Advisors at 1-800-226-2370.
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